This is the 2007 version. Click here for the 2017 chapter 12 table of contents.


Autism is a problem that affects certain children from birth onward. It is far less common than Down Syndrome but receives a lot of attention because of its intriguing characteristics, and it has become more frequently diagnosed in recent years-a fact which is controversial in itself. Nobody is sure whether some environmental cause of autism is becoming more common or whether people are simply more aware of autism now, compared to a few decades ago.

DSM-IV categorizes autism as a Pervasive Developmental Disorder because it tends to influence all aspects of a child's life. Twin studies suggest autism is a genetic disorder, although the nature of the disorder has not been pinned down as it has in the case of Down Syndrome (Ritvo, 1985).

What is autism?

The autistic baby fails to respond to cuddling and seems cut off from other people. He or she does not progress as quickly as other children. Speech onset is delayed, if the child learns to speak at all. . In the days before newborns were screened for hearing problems, parents would often bring an autistic child to a doctor because they suspected that the child is deaf. It would turn out the child was not deaf but was ignoring people. To this day, one of the informal ways to screen for autism in a child younger than one year of age is to call the baby's name and see if it turns toward the voice. Normal babies will do this around eight or nine months of age. Autistic babies will not do it.

What are ingredients of Kanner's description?

Social aloneness is one part of the autistic syndrome. There are many other characteristics that autistic children have sometimes but not always. Together they form a distinctive syndrome. Leo Kanner, sometimes called the father of child psychiatry, mentioned many of these characteristics in his original description of the syndrome in 1947:

—As a baby, the autistic child fails to assume the normal anticipatory posture prior to being picked up.

—The children often show an excellent rote memory for "poems, songs, lists of presidents and the like."

—When and if the child learns to speak, the first sentences tend to be "parrot-like repetitions of word combinations," sometimes echoed immediately and sometimes stored for long periods and "uttered at a later date."

—Autistic children typically have difficulty learning to use pronouns correctly; the child speaks of himself as "you" and of another person as "I," failing to switch the words to suit the context of who is speaking.

—The child may show an "obsessive desire for sameness" and become enraged when a piece of furniture is moved.

—The child may show a fascination with spinning objects and regularly occurring environmental events.

—Autistic children typically show no evidence of abnormality in the EEG and no other signs of brain damage.

—Autistic children are often strikingly good looking, unlike many retarded and brain-damaged children.

—Autistic children often excel at a particular, limited skill, such as finding prime numbers, memorizing calendar dates, or composing music.

What was portrayed in the movie Rain Man ?

The late-1980s film Rain Man raised public awareness of autism. Before the movie came out, this peculiar syndrome was unfamiliar to many people. Rain Man featured actor Dustin Hoffman as an autistic man. He spent time getting to know some autistic adults, and his character was a composite formed of almost all the classic features of autism that are (in the real world) seldom found together in the same person. He portrayed a high-functioning autistic (sometimes abbreviated HFA) who could read and write and talk fluently. DSM-IV does not include a category for high-functioning autistics, but provides a different diagnosis—Asperger's Disorder— that many professionals believe is the same thing as mild or "high-functioning" autism.

What factor predicts ultimate success in adjustment, for autistics?

About 40% of autistic children never learn to speak. Those who never learn to speak seldom learn to function well enough to live outside an institution. The 60% of autistic children who do learn to speak have a better chance of living a productive life. Many autistics are gainfully employed, especially if they have special skills that can be used in a profession.

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